Getting back in the Game

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George Stinnett

SteveWhitemore2The throw was high and hard, right over the plate. A perfect strike. A common result for 16-year-old Steve Whitmire Jr. of Virginia Beach.

But the sudden, unexpected pain in his right shoulder was a different story.

The Kempsville High School varsity baseball pitcher, participating in team tryouts this past September for the fall season, had never experienced anything quite like it since starting to play at the age of four. He’d felt good and thrown hard all summer and during the previous spring while playing for various school and recreation league teams. It was the same 10- to 11-month season he’d followed since he was 12.

Steve gave his arm a day’s rest, but throwing continued to hurt. So he rested another week. After he pitched four innings during a game, the arm again felt good. Until the next day – when it really began to hurt.

He was out for the rest of the season, and his team’s athletic trainer suggested he make an appointment with CHKD’s sports medicine specialist Joel Brenner, MD, for evaluation.

SteveWhitemore3Fortunately for Steve, CHKD had recently opened the Health and Surgery Center in the Princess Anne area which houses a dedicated sports medicine program. In addition to Dr. Brenner and orthopedic surgeon Marc Cardelia and his partners from Children’s Orthopedics and Sports Medicine, the program includes specially trained sports physical therapists and a state-of-the-art facility to help with the rehabilitation of injured young athletes. Steve became one of the first patients at the new facility.

“Most people think of sports injuries as sudden accidents – twists, turns and collisions on the field,” said Kimberly Kranz, CHKD’s sports medicine program manager. “We treat a lot of those, but about 75 percent of the injuries we see are due to overuse.”

Overuse injuries occur when a young athlete repeats the same motion too often, putting stress on tissues around the joints without giving them adequate time to recover.

A physical examination and X-rays of Steve’s shoulder revealed inflammation around the joint, a common injury in young baseball pitchers. It can often be treated conservatively with physical therapy, and such was his case.

SteveWhitemore4Physical therapist Tina Dolenti, one of nine sports medicine PTs on the CHKD teams located at Princess Anne, Kempsville, Greenbrier and Oyster Point, was assigned to work with Steve. She has a special interest and graduate training in pitching.

“Proper pitching mechanics improve accuracy and speed and help decrease the risk of shoulder and elbow injury in young players,” she said. “To have the proper mechanics, kids need to be strong in the hips, core and shoulder and have an appropriate range of motion.”

So that’s what Dolenti and Steve went to work on during twice-a-week therapy sessions at CHKD’s Princess Anne facility. They spent a lot of time talking about how the injury occurred and how to prevent a recurrence. Pitching technique was high on the list, but actual throwing would come later.

During the first weeks of therapy, Steve was given exercises – both for the gym and at home – to improve shoulder strength and flexibility.

The initial therapy was very helpful, he said. Within two weeks, the pain was significantly reduced.

“Tina got right to the source of the pain and knew how to keep it from coming back,” Steve said. “She knew a lot about pitching. I never doubted anything she said, and I paid close attention.”

Soon, Steve was ready to throw. So, out came Dolenti’s video camera.

SteveWhitemore1The sports medicine facility at Princess Anne is equipped with a “pitching lane,” complete with a mound, a home plate, a target and a large netted area to contain the throws. Dolenti records each throw in slow motion and transfers the images to a computer where she can do a frame-by-frame analysis of the pitcher’s mechanics – from before the windup to past the follow-through.

“We go over everything from feet placement and head movement to shoulder and arm movement,” Dolenti said. “In Steve’s case, he leaves his arm behind his body a lot, putting extra stress on his shoulder and overusing his biceps, causing tendonitis.”

The ultimate goal is getting the young athlete back in the game, pain free and preventing another injury.

“The biggest difference between children’s sports medicine and adult sports medicine is that children – especially teens – are still growing and have different mechanics,” Kranz said. “We care for injured young athletes exclusively. Having a program and facility just for kids also helps keep them motivated and improving.”

Steve is taking all the help and coaching to heart, and he and his parents, Steve Sr. and Sandy, appreciate the convenience the Princess Anne center provides.

“I’m looking forward to getting started again in February, and I’m focusing hard on what Tina is telling me,” the young pitcher said. “It’s really a good deal that CHKD has this program and facility in Virginia Beach. I live just down the road, and being so close allows me to drive to my appointments and still do the other stuff I need to do for school and at home.”

Steve aspires to play baseball in college. Getting back in the game – and staying there – is his next big step.

Dr. Brenner practices with Children’s Specialty Group PLLC at CHKD. For more information, visit chkd.org/Services/SportsMedicine.

This story was featured in the first quarter 2009 issue of KidStuff, a publication of Children's Hospital of The King's Daughters. Click to read more patients' stories.

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